Information Collection

VA Conjoint Survey - External Communication

IC 218836 under ICR 201403-2900-007 · OMB 2900-0770.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0770 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 10-1500188(WS) VA Conjoint Survey - External Communication	Form and Instruction
10-1500188(WS) VA External Communication Conjoint Questionnaire VA External Communication Conjoint Questionnaire 11-12-2015.docx	Form and Instruction
VA Generic Fast-Track Clearance Request_VHA OSI Conjoint Analysis_External Communications Conjoint_10 302015.docx VA Generic Fast Track Clearance Request	IC Document
VA Generic Fast-Track Clearance Request_VHA OSI Conjoint Analysis_External Communications Conjoint_10 302015.docx VA Generic Fast Track Clearance Request	IC Document

IC Title:

VA Conjoint Survey - External Communication

Agency IC Tracking Number:

2900-0770

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	10-1500188(WS)	VA External Communication Conjoint Questionnaire	VA External Communication Conjoint Questionnaire 11-12-2015.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 800

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	800	800
Annual IC Time Burden (Hours)	200	200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
VA Generic Fast Track Clearance Request	VA Generic Fast-Track Clearance Request_VHA OSI Conjoint Analysis_External Communications Conjoint_10 302015.docx	11/03/2015
VA Generic Fast Track Clearance Request	VA Generic Fast-Track Clearance Request_VHA OSI Conjoint Analysis_External Communications Conjoint_10 302015.docx	11/03/2015

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.